Bone Marrow Aspiration Needle

ABSTRACT

A bone marrow aspiration assembly including an outer cannula assembly, an inner cannula assembly, and a flexible seal. The outer cannula assembly includes an outer handle and an outer cannula defining a first passageway and including a plurality of first openings between a first end and a second end of the first passageway. The inner cannula assembly includes an inner handle and an inner cannula defining a second passageway and is configured to be received within the first passageway. The inner cannula includes a plurality of second openings between a first end and a second end of the second passageway. The flexible seal is mounted to the inner handle and positioned such that the seal contacts the outer cannula assembly when the inner cannula assembly is in cooperation with the outer cannula assembly to create a substantially airtight seal therebetween.

CROSS-REFERENCE TO RELATED APPLICATION

This application is a continuation-in-part of U.S. patent application Ser. No. 12/849,412 filed on Aug. 3, 2010, the entire disclosure of which is incorporated herein by reference.

FIELD

The present disclosure relates to bone marrow aspiration needles.

BACKGROUND

This section provides background information related to the present disclosure which is not necessarily prior art.

Autologous stem cell therapies often utilize a patient's bone marrow or concentrated bone marrow aspirate to deliver autologous adult mononuclear stem cells to the patient for the treatment of a wide variety of disorders. Concentrated autologous cell therapies utilize in vitro cell culture to expand a desired cell line, or a point-of-care device to concentrate the mononuclear cell-rich fraction (CRF), for delivery to a desired treatment site. An exemplary point-of-care device is the MarrowStim™ device by Biomet Biologics, LLC of Warsaw, Ind.

Concentration of the mononuclear CRF is limited by the number of recovered mononuclear cells in the aspirate. Often, aspiration of four 1 ml aspirates recovers almost twice the number of osteoblast progenitor cells as compared to a single 4 ml aspirate. This discrepancy is often attributed to aspirate dilution from peripheral blood. Harvesting smaller volumes of aspirate from a variety of different locations, such as along the curved iliac crest of the pelvis, can improve the baseline and concentrated mononuclear CRF, which will lead to more effective stem cell therapies.

SUMMARY

This section provides a general summary of the disclosure, and is not a comprehensive disclosure of its full scope or all of its features.

The present teachings provide for a bone marrow aspiration assembly including an outer cannula assembly, an inner cannula assembly, and a flexible seal. The outer cannula assembly includes an outer handle and an outer cannula defining a first passageway and including a plurality of first openings between a first end and a second end of the first passageway. The inner cannula assembly includes an inner handle and an inner cannula defining a second passageway and is configured to be received within the first passageway. The inner cannula includes a plurality of second openings between a first end and a second end of the second passageway. The flexible seal is mounted to the inner handle and positioned such that the seal contacts the outer cannula assembly when the inner cannula assembly is in cooperation with the outer cannula assembly to create a substantially airtight seal therebetween. The inner cannula is longitudinally and axially movable relative to the outer cannula to simultaneously selectively align at least one first opening with at least one second opening to permit aspiration of bone marrow therethrough and to misalign at least one first opening and at least one second opening to restrict aspiration of bone marrow therethrough.

The present teachings further provide for a bone marrow aspiration assembly including an outer cannula assembly, an inner cannula assembly, and a polymeric seal. The outer cannula assembly includes an outer handle and an outer cannula defining a plurality of elongated slots that are arranged in distal, intermediate, and proximal groups along a first length of the outer cannula. Each group includes only a pair of opposing elongated slots, the elongated slots of neighboring groups are arranged about 120° relative to each other. The inner cannula assembly includes an inner handle and an inner cannula defining a plurality of circular openings that are arranged in distal, intermediate, and proximal groups along a second length of the inner cannula. Each group includes opposing circular openings, the circular openings of neighboring groups are longitudinally aligned. A polymeric seal is between the inner cannula assembly and the outer cannula assembly. The inner cannula is rotated radially to selectively align the circular openings of only one of the distal, intermediate, and proximal groups of the inner cannula with the elongated slots of only one of the distal, intermediate, and proximal groups of the outer cannula to permit aspiration therethrough.

The present teachings also provide for a bone marrow aspiration assembly including an outer cannula assembly, an inner cannula assembly, and a polymeric seal. The outer cannula assembly includes an outer handle with a locking knob. The outer cannula defines a plurality of elongated slots that are arranged in distal, intermediate, and proximal groups along a first length of the outer cannula. Each group includes only a pair of opposing elongated slots. The elongated slots of neighboring groups are arranged about 120° relative to each other. The inner cannula assembly includes an inner handle with a locking skirt defining a first locking channel, a second locking channel, and a third locking channel spaced apart at about 120° intervals around the locking skirt. Each of the first locking channel, the second locking channel, and the third locking channel are operable to individually cooperate with the locking knob of the outer handle. The inner cannula defines a plurality of circular openings that are arranged in distal, intermediate, and proximal groups along a second length of the inner cannula. Each group includes opposing circular openings. The circular openings of neighboring groups are longitudinally aligned. A polymeric seal is between the inner cannula assembly and the outer cannula assembly. The polymeric seal includes a square cross-section. The inner cannula assembly is rotated radially and connected to the outer cannula assembly by selectively locking the locking knob within one of the first, second, or third locking channels to selectively align the circular openings of only one of the distal, intermediate, and proximal groups of the inner cannula with the elongated slots of only one of the distal, intermediate, and proximal groups of the outer cannula to permit aspiration therethrough

Further areas of applicability will become apparent from the description provided herein. The description and specific examples in this summary are intended for purposes of illustration only and are not intended to limit the scope of the present disclosure.

DRAWINGS

The drawings described herein are for illustrative purposes only of selected embodiments and not all possible implementations, and are not intended to limit the scope of the present disclosure.

FIG. 1 is a perspective view of a bone marrow aspiration assembly according to the present teachings;

FIG. 2 illustrates an inner needle assembly separated from an outer needle assembly of the bone marrow aspiration assembly of FIG. 1;

FIG. 3 is a cross-sectional view of the bone marrow aspiration assembly;

FIG. 3A is an enlarged cross-sectional view of the bone marrow aspiration assembly showing cooperation between the inner needle assembly and the outer needle assembly;

FIG. 4 is a perspective view of an insert of the outer needle assembly;

FIG. 4A is a cross-sectional view of the insert of FIG. 4;

FIG. 5 is a top view of the insert;

FIG. 6 is a perspective view of a handle of the outer needle assembly;

FIG. 7A illustrates a distal end of each of an outer cannula (right side of Figure) and an inner cannula (left side of Figure) of the bone marrow aspiration assembly;

FIG. 7B illustrates the inner cannula seated within the outer cannula;

FIG. 8A illustrates a distal end of each of another outer cannula (right side of Figure) and another inner cannula (left side of Figure) according to the present teachings;

FIG. 8B illustrates a distal end of another outer cannula (right side of Figure) and another inner cannula (left side of Figure) according to the present teachings;

FIG. 8C illustrates a distal end of a further outer cannula (right side of Figure) and a further inner cannula (left side of Figure) according to the present teachings;

FIG. 9 is a perspective view of a distal side of a handle of the inner needle assembly;

FIG. 9A is a perspective view of a connection region of the handle of the inner needle assembly;

FIG. 9B is a planar view of a distal end of the connection region;

FIG. 10 is a perspective view of a trocar (left side of Figure) configured to be received by the outer needle assembly (right side of Figure);

FIG. 11 is an assembled view of the trocar in cooperation with the outer needle assembly;

FIG. 12 is a posterior view of a pelvis with the inner cannula and the outer cannula engaging the iliac crest;

FIG. 13 is a cross-sectional view of the pelvis and illustrates the bone marrow aspiration assembly engaging the pelvis, the assembly including a trocar mounted to the outer needle assembly;

FIG. 14 is a cross-sectional view of the pelvis and illustrates the bone marrow aspiration assembly engaging the pelvis, the assembly including the outer needle assembly and the inner needle assembly;

FIG. 15A is a top, cross-sectional view of interaction between the inner needle assembly and the outer needle assembly in a first position;

FIG. 15B is a top, cross-sectional view of interaction between the inner needle assembly and the outer needle assembly in a second position;

FIG. 15C is a top, cross-sectional view of interaction between the inner needle assembly and the outer needle assembly in a third position;

FIG. 16 is a cross-sectional view of the pelvis and the bone marrow aspiration assembly of FIG. 1 in the first position engaging the pelvis, and a syringe for aspirating bone marrow from the pelvis;

FIG. 17 is a cross-sectional view of the bone marrow aspiration assembly engaging the pelvis with the inner needle assembly and the outer needle assembly each in a first position such that openings of outer and inner distal opening groups are aligned;

FIG. 18 is a cross-sectional view of the bone marrow aspiration assembly engaging the pelvis with the inner needle assembly and the outer needle assembly each in a second position such that openings of outer and inner intermediate opening groups are aligned;

FIG. 19 is a cross-sectional view of the bone marrow aspiration assembly engaging the pelvis with the inner needle assembly and the outer needle assembly each in a third position such that openings of outer and inner proximal opening groups are aligned;

FIG. 20 illustrates an outer needle assembly (right side of Figure) and an inner needle assembly (left side of Figure) of another bone marrow aspiration assembly of the present teachings;

FIG. 20A is another distal tip that may be provided with the outer needle assembly of FIG. 20;

FIG. 21 is a perspective view of a bone piercing needle of the present teachings;

FIG. 22 is a posterior view of a pelvis with the bone piercing needle of FIG. 21 and the bone marrow aspiration assembly of FIG. 20 seated therein;

FIG. 23A illustrates a curved introducer needle according to the present teachings;

FIG. 23B illustrates a flexible needle assembly according to the present teachings;

FIG. 24 is a cross-sectional view of the pelvis with the bone piercing needle of FIG. 21, the introducer needle of FIG. 23A, and the flexible needle of FIG. 23B seated therein;

FIG. 24A is similar to FIG. 24, but with the flexible needle including a plurality of circular openings;

FIG. 25 is a perspective view of another bone marrow aspiration assembly according to the present teachings;

FIG. 26 is an exploded view of the bone marrow aspiration assembly of FIG. 25 according to the present teachings;

FIG. 27 is an enlarged cross-sectional view of the bone marrow aspiration assembly of FIG. 25 showing cooperation between an inner needle assembly and an outer needle assembly;

FIG. 28 is a cross-sectional view of the bone marrow aspiration assembly of FIG. 25 taken along line 28-28 of FIG. 25;

FIG. 29 is a perspective view of an inner handle of the bone marrow aspiration assembly of FIG. 25;

FIG. 30 is a perspective view of cooperation between an inner needle assembly and an outer needle assembly of the bone marrow aspiration assembly of FIG. 25; and

FIG. 31 is another perspective view of cooperation between the inner needle assembly and the outer needle assembly of the bone marrow aspiration assembly of FIG. 25.

Corresponding reference numerals indicate corresponding parts throughout the several views of the drawings.

DETAILED DESCRIPTION

Example embodiments will now be described more fully with reference to the accompanying drawings.

With initial reference to FIG. 1 and FIG. 2, a bone marrow aspiration assembly according to the present teachings is generally illustrated at reference numeral 10. The assembly 10 generally includes an outer needle assembly 12 and an inner needle assembly 14.

The outer needle assembly 12 includes an outer handle 16 and an outer cannula 18 extending therefrom. With additional reference to FIG. 3 and FIG. 3A, the outer handle 16 includes a proximal surface 20 and a distal surface 22 opposite to the proximal surface 20. The distal surface 22 has a raised neck 24 at a center thereof. The raised neck 24 includes a distal portion 26.

With reference to FIGS. 3 and 3A, the outer handle 16 defines a through bore 28 extending between the proximal surface 20 and a center of the distal portion 26 of the raised neck 24. A longitudinal axis A extending through an axial center of the through bore 28 is perpendicular to each of a plane extending across the proximal surface 20, a plane extending across the distal surface 22, and a plane extending across the distal portion 26 of the raised neck 24.

With reference to FIG. 3A, at approximately a mid-point of the through bore 28, the outer handle 16 defines a stepped, annular retention surface 30. Between the retention surface 30 and the proximal surface 20 is an annular flange 31 protruding into the through bore 28 toward the longitudinal axis A. The outer handle 16 defines a plurality of diameter areas of the through bore 28 having diameters of various sizes.

A first area 29 is between the proximal surface 20 and the flange 31. From the proximal surface 20, the first area 29 tapers inward toward the longitudinal axis A, and retains a generally uniform diameter about the longitudinal axis A as it extends in the distal direction (toward the distal surface 22) until it reaches the flange 31. A second area 33 is at the flange 31. The second area 33 has a diameter that is smaller than the diameter of the first area 29. A third area 35 is adjacent to the flange 31 on a distal side thereof (closest to the distal surface 22). The third area 35 has a diameter that is similar in size to the diameter of the first area 29. A fourth area 37 is between the annular retention surface 30 and the third area 35. A fifth area 39 is between the annular retention surface 30 and the distal portion 26 of the neck 24. The fifth area 39 has the smallest diameter, which is generally uniform throughout its length. The fourth area 37 has a diameter that is greater than the diameter of the fifth area 39, but smaller than the diameter of the second area 33.

With additional reference to FIGS. 4 and 4A, an insert 32 is seated within the through bore 28. The insert 32 defines a center channel 34 having a longitudinal axis that is common with the longitudinal axis A. Near a proximal end 36 of the insert 32, but spaced apart therefrom, is an annular recess 38 extending around an outer surface 40 of the insert 32. Proximate to a distal end 42 of the insert 32, but spaced apart therefrom, is an annular collar 44 extending from the insert 32 in a direction perpendicular to the longitudinal axis A. Between the annular recess 38 and the annular collar 44, but closer to the annular recess 38, is a pair of flexible retention fins 46.

The diameter of the center channel 34 is greatest at a portion 48 that is at the proximal end 36. The diameter of the center channel 34 tapers inward from the proximal end 36 to a point along the length of the center channel 34 that is approximately even with the fins 46. The remainder of the center channel 34, which extends along the longitudinal axis A to the distal end 42 has a generally uniform diameter.

With additional reference to FIG. 5, protruding from a portion of the insert 32 defining the large diameter portion 48 of the center channel 34 are a series of raised surfaces or bumps 50. A first pair 52 a, a second pair 52 b, and a third pair 52 c of the bumps 50 are arranged at 120° intervals around the large diameter portion 48. The two bumps 50 of each pair 52 a, 52 b, and 52 c are spaced apart to securely receive a portion of the inner handle 90 therebetween, as described herein. FIGS. 4 and 5 also illustrate six planar surfaces 54 of the outer surface 40, which are in a hexagonal arrangement and are between the collar 4 and the fins 46. The planar surfaces 54 restrict rotational movement of the insert 32 about the longitudinal axis A when seated in the through bore 28.

As illustrated in FIGS. 3A and 6 for example, the insert 32 is positioned within the through bore 28 of the handle 16 such that the proximal end 36 is at, or closely proximate to, the plane extending across the proximal surface 20 of the outer handle 16 and such that the distal end 42 extends beyond the distal portion 26 of the raised neck 24. The collar 44 abuts the distal portion 26 of the raised neck 24 and the fins 46 are seated on the retention surface 30. The handle 16 can be manufactured such that the insert 32 is a separately formed component that is inserted into the through bore 28 at the distal portion 26 until the annular, flexible fins 46 pass across the annular retention surface 30, at which point they expand from a contracted or first position to an expanded or second position to contact the annular retention surface 30. The collar 44 and the flexible fins 46 retain the insert 32 within the through bore 28.

Alternatively, the handle 16 can be manufactured such that the insert 32 is molded together with the remainder of the handle 16 or the insert 32 can be formed integral with the remainder of the handle 16 during manufacturing. The handle 16 and the insert 32 may also be manufactured in any other suitable manner. Both the handle 16 and the insert 32 can be made of any suitable material, such as a suitable polymer.

With reference to FIGS. 2 and 3 for example, the outer cannula 18 includes a proximal end 58 and a distal end 60 and defines an outer cannula passageway 62 that extends an entire length of the outer cannula 18, from the proximal end 58 to the distal end 60. A longitudinal axis A extending through an axial center of the outer cannula passageway 62 is aligned with the longitudinal axis A of the through bore 28 (see FIG. 3); thus the longitudinal axis of the outer cannula passageway 62 is also designated with reference letter A.

With additional reference to FIG. 7A, the distal end 60 is open and includes a plurality of sharpened edges or teeth 64. The outer cannula 18 defines a plurality of openings 66 between the distal end 60 and the proximal end 58. The openings 66 provide communication between the passageway 62 and an exterior of the outer cannula 18.

As illustrated in FIG. 2, an outer distal set 68 and an outer proximal set 70 of the openings 66 are provided. Each of the outer distal set 68 and the outer proximal set 70 include multiple openings 66 spaced apart along the longitudinal axis A of the outer cannula 18. The outer distal set 68 is substantially similar to the outer proximal set 70. The description of the outer distal set 68 below is therefore also sufficient to describe the outer proximal set 70. Only one of the outer distal set 68 and the outer proximal set 70 may be provided in some applications. Additional sets of the openings 66 may also be included.

With specific reference to FIG. 7A, the outer distal set 68 will now be described. The outer distal set 68 includes an outer distal opening group 72 a, an outer intermediate opening group 72 b, and an outer proximal opening group 72 c. The different outer opening groups 72 a, 72 b, and 72 c are not radially aligned, but rather radially offset 120° from each other about axis A.

The outer distal opening group 72 a includes a first distal array 74 a of openings 66 and a second distal array 74 b of openings 66. The first and the second distal arrays 74 a and 74 b are spaced 180° apart about the radius of the outer cannula 18. Each of the first and the second distal arrays 74 a and 74 b include a plurality of the openings 66 aligned parallel to the longitudinal axis A in the distal-to-proximal direction. The first distal array 74 a includes four of the openings 66 and the second distal array 74 b includes three of the openings 66. None of the openings 66 of the first distal array 74 a are aligned in the distal to proximal direction with any of the openings 66 of the second distal array 74 b, but rather the openings 66 are spaced apart.

The intermediate opening group 72 b includes a first intermediate array 76 a of openings 66 and a second intermediate array 76 b of openings 66, which are each substantially similar to the first and the second distal arrays 74 a and 74 b respectively. The only substantial difference between the intermediate opening group 72 b and the distal opening group 72 a is that the first and the second intermediate arrays 76 a and 76 b are each radially rotated or shifted approximately 120° about the longitudinal axis A as compared to the first and the second distal arrays 74 a and 74 b.

The proximal opening group 72 c includes a first proximal array 78 a of openings 66 and a second proximal array 78 b of openings 66. The first proximal array 78 a is substantially similar to both the first intermediate array 76 a and the first distal array 74 a. The second proximal array 78 b is substantially similar to both the second intermediate array 76 b and the second distal array 74 b. The only substantial difference between the proximal opening group 72 c and both the intermediate opening group 72 b and the distal opening group 72 a is that the first and the second proximal arrays 78 a and 78 b are each radially rotated or shifted approximately 120° about the longitudinal axis A such that the first and the second proximal arrays 78 a and 78 b are not radially aligned with either the first and the second intermediate arrays 76 a and 76 b or the first and the second distal arrays 74 a and 74 b.

With additional reference to FIG. 8A, the outer cannula 18 can alternatively include elongated slots 80, instead of the openings 66, which each extend parallel to the longitudinal axis A. Each of the arrays 74 a, 74 b (obscured behind array 74 a in FIG. 8A), 76 a, 76 b, 78 a, and 78 b include two slots 80 that are radially aligned with each other. The slots 80 of each of the first arrays 74 a, 76 a, and 78 a are aligned with the slots 80 of each of the corresponding second arrays 74 b, 76 b, and 78 b such that they overlap along the longitudinal axis A. The distal opening group 72 a, the intermediate opening group 72 b, and the proximal opening group 72 c are each orientated such that the slots 80 of the different opening groups 72 a, 72 b, and 72 c are not radially aligned, but rather offset by 120° degrees each as illustrated. This offset can also be 180°.

With additional reference to FIG. 8B, each of the outer cannula 18 arrays 74 a, 74 b (obscured behind array 74 a in FIG. 8B), 76 a, 76 b, 78 a, and 78 b can include, in place of the spaced apart slots 80 of FIG. 8A, a single elongated slot 80 that extends parallel to the longitudinal axis A. The single slots 80 of each of the first arrays 74 a, 76 a, and 78 a, are aligned with the single slots 80 of each of the corresponding second arrays 74 b, 76 b, and 78 b such that they overlap along the longitudinal axis A. The distal opening group 72 a, the intermediate opening group 72 b, and the proximal opening group 72 c are each orientated such that the slots 80 of the different opening groups 72 a, 72 b, and 72 c are not radially aligned, but rather offset by 120°. Further, and as illustrated in FIG. 8C, in place of each of the single slots 80, the outer cannula 18 can include four circular openings 128 in the same orientation as the slots 80.

With reference to FIGS. 3 and 3A, the proximal end 58 of the outer cannula 18 includes a pair of opposing flared surfaces 82 that extend outward and away from the longitudinal axis A. At least a portion of the proximal end 58, including the flared surfaces 82, is seated within the insert 32 to mount the outer cannula 18 to the outer handle 16 by way of the insert 32. The flared surfaces 82 extend within the portion of the insert 32 defining the center channel 34 to secure the outer cannula 18 to the insert. The outer cannula 18 may also be secured to the insert 32 with a suitable adhesive or the insert 32 can be molded to the outer cannula 18 during manufacturing. The outer cannula passageway 62 is aligned with the center channel 34 of the insert 32 to provide a continuous passage from the proximal surface 20 of the handle 16 to the distal end 60 of the outer cannula 18.

The outer cannula 18 can be made of any suitable polymer or metal and can be rigid or flexible, as further discussed herein. For example, rigid stainless steel can be used, as well as flexible material, such as Nitinol.

With reference to FIG. 2, the inner needle assembly 14 generally includes an inner handle 90 and an inner cannula 92 that extends from the inner handle 90 along longitudinal axis B. The inner handle 90 includes a distal surface 94 and a proximal surface 96 that is opposite to the distal surface 94. With continued reference to FIG. 2 and additional reference to FIGS. 9, 9A, and 9B, the distal surface 94 includes a connection region 98 at a center thereof. The connection region 98 includes a connection cone 100 between two connection tabs 102.

The connection cone 100 has a tapered outer surface 104 that is tapered in the proximal to distal direction such that a diameter of the outer surface 104 is greatest at the distal surface 94. Extending from the tapered outer surface 104 is a first ridge 106 a, a second ridge 106 b, and a third ridge 106 c that are each positioned at 120° intervals about the outer surface 104 of the cone 100. The ridges 106 are elongated and extend along a portion of a length of the outer surface 104. An inner surface 108 of the connection cone 100 defines an inner connection channel 110 that extends through the connection cone 100. The inner surface 108 is cylindrical and has a generally uniform diameter throughout, which provides the inner connection channel 110 with a uniform diameter.

The connection tabs 102 each terminate at a tooth 112. The teeth 112 extend from their respective connection tabs 102 towards each other and oppose each other. The teeth 112 are sized to be received within the annular recess 38 of the insert 32.

The inner connection channel 110 is aligned along the longitudinal axis B with, and in communication with, a syringe receptacle 114 defined by the inner handle 90, as illustrated in FIG. 3A for example. The receptacle 114 extends from the proximal surface 96 and into a portion of the inner handle 90. The receptacle 114 has an inner diameter that is greatest at the proximal surface 96 of the inner cannula handle 90. From the proximal surface 96, the inner diameter of the syringe receptacle 114 tapers inward toward the longitudinal axis B, which is at an axial center of the syringe receptacle 114 and is co-linear with the longitudinal axis A when the inner needle assembly 14 is in cooperation with the outer needle assembly 12, as illustrated in FIGS. 3 and 3A.

The inner cannula 92 includes a proximal end 120 extending to the receptacle 114 and a distal end 122 that terminates at a closed tip 124. The inner cannula 92 defines an inner cannula passageway 126, as illustrated in FIGS. 3 and 3A, for example. The longitudinal axis B extends through an axial center of the inner cannula passageway 126. Between the proximal end 120 and the distal end 122 of the inner cannula 92 are a plurality of openings or ports 128, which provide communication between the inner cannula passageway 126 and an exterior of the inner cannula 92. As illustrated in FIG. 2, the openings 128 are arranged in an inner distal set 130 and an inner proximal set 132. The inner distal set 130 is substantially similar to the inner proximal set 132 and thus the below description of the inner distal set 130 also describes the inner proximal set 132. As with the outer distal and proximal sets 68 and 70, only one of the inner sets 130 and 132 need be provided, or additional inner sets of the openings 128 can be provided depending on the application. The number of sets of openings 128 provided will generally correspond to the number and sets of openings 66 provided.

With reference to FIG. 7A, the inner distal set 130 includes an inner distal opening group 134 a, an inner intermediate opening group 134 b, and an inner proximal opening group 134 c. Unlike the outer opening groups 72 a, 72 b, and 72 c of the outer distal set 68, the inner opening groups 134 a, 134 b, and 134 c are all radially aligned along the longitudinal axis B.

The inner distal opening group 134 a includes a first inner distal array 136 a of openings 128 and a second inner distal array 136 b of openings 128. The first inner distal array 136 a is radially spaced apart 180° from the second inner distal array 136 b. The first inner distal array 136 a is substantially similar to the first outer distal array 74 a of openings 66. The second inner distal array 136 b is substantially similar to the second outer distal array 74 b. Thus, the first inner distal array 136 a includes four openings 128 radially aligned and spaced apart along a line parallel to the longitudinal axis B and the second inner distal array 136 b includes three openings 128 that are radially aligned and spaced apart along a line parallel to the longitudinal axis B. The openings 128 of the first inner distal array 136 a and the openings 128 of the second inner distal array 136 b are not aligned in the distal to proximal direction, but rather staggered such that the openings 128 of the second inner distal array 136 b are between the openings 128 of the first inner distal array 136 a in the distal to proximal direction of the inner cannula 92.

The inner intermediate opening group 134 b and the inner proximal opening group 134 c are radially aligned with, and are substantially similar to, the inner distal opening group 134 a, but spaced apart from the inner distal opening group 134 a along the longitudinal axis B. Therefore, the description of the inner distal opening group 134 a is also sufficient to describe both the inner intermediate opening group 134 b and the inner proximal opening group 134 c.

As illustrated in FIG. 3A, the proximal end 120 of the inner cannula 92 includes a syringe connector 140 having external threads 142. The syringe connector 140 may have any configuration suitable to couple a syringe to the inner cannula 92 in order to aspirate material there through, such as bone marrow, as further described herein.

The inner cannula 92 can be made of a suitable polymer or metal and can be rigid or flexible. For example, rigid stainless steel can be used, as well as flexible material, such as Nitinol.

As illustrated in FIG. 8A, in place of the circular openings 128 the inner cannula 92 can include openings 129 shaped as elongated slots extending parallel to the longitudinal axis B. Each inner opening group 134 a, 134 b, and 134 c can include a pair of the slotted openings 129 orientated at 180° relative to each other. The pairs of openings 129 of the inner distal opening groups 134 a, 134 b, and 134 c are each radially aligned.

As illustrated in FIG. 8B, each of the slotted openings 129 can be replaced with a group of four circular openings 128 provided in the same orientation as the slotted openings 129. With reference to FIG. 8C, the inner cannula 92 with slotted openings 129 can also be used in conjunction with the outer cannula 18 including the circular openings 128. Use of the slotted openings 80/129 facilitates alignment between openings of the outer cannula 18 and the inner cannula 92, which permits use of greater manufacturing tolerances leading to lower production costs. For example and with reference to FIG. 8A, alignment between the slots 80 of the outer cannula 18 and the elongated slots 129 of the inner cannula 92 is easier than alignment between, for example, the circular openings 66 and 128 of FIG. 7A.

With additional reference to FIGS. 10 and 11, a trocar is illustrated at reference numeral 200. The trocar 200 generally includes a trocar handle 202 and a trocar needle 204 extending therefrom. The trocar handle 202 includes a distal surface 206 and a proximal surface 208 that is opposite to the distal surface 206. The trocar needle 204 includes a proximal end 210 and a distal end 212. The proximal end 210 is attached to a connector 214 at a center of the distal surface 206 of the trocar handle 202 with a press-fit, for example. The distal end 212 includes a pointed tip 216. The trocar needle 204 is rigid and made from any suitable rigid material, such as a suitable metal. At opposite sides of the connector 214 are locking tabs 218 configured to cooperate with the annular recess 38 of the insert 32 of the outer handle 16 to secure the trocar 200 to the outer handle 16, as further described herein.

With continued reference to FIGS. 1-11 and additional reference to FIGS. 12-19, use of the outer needle assembly 12, the inner needle assembly 14, and the trocar 200 to aspirate bone marrow will now be described. While aspiration of bone marrow from a posterior iliac crest 302 of a pelvis 300 is described, the outer needle assembly 12, the inner needle assembly 14, and the trocar 200 can be used to retrieve/isolate a variety of biological materials from a variety of different sources.

With initial reference to FIGS. 12 and 13, cortical bone 304 and cancellous bone 306 of the iliac crest 302 is initially pierced with a suitable piercing device, such as the trocar 200. As illustrated in FIG. 13, the trocar 200 can be coupled with the outer needle assembly 12 such that the trocar needle 204 extends through the outer cannula passageway 62 and the distal end 212 of the trocar needle 204, including the pointed tip 216, extends beyond the teeth 64 of the distal end 60 of the outer cannula 18. The teeth 64 facilitate piercing and cutting of the cortical bone 304 and the cancellous bone 306 of the iliac crest 302.

The trocar 200 can be secured to the outer needle assembly 12 through cooperation between the locking tabs 218 of the handle 202 and the annular recess 38 of the insert 32 of the outer handle 16. Once the outer cannula 18 is in a desired position and at a desired bone depth within the cancellous bone 306, the trocar 200 can be removed from cooperation with the outer needle assembly 12, which is left in position in the iliac crest 302.

With reference to FIG. 14, the inner needle assembly 14 is coupled to the outer needle assembly 12 seated in the iliac crest 302 by inserting the inner cannula 92 within the outer cannula 18 such that the distal end 122 of the inner cannula 92, including the closed tip 124, extends beyond the distal end 60 of the outer cannula 18. The connection tabs 102 are coupled to the annular recess 38 of the insert 32 of the outer handle 16 to lock the inner needle assembly 14 to the outer needle assembly 12. The connection cone 100 of the inner cannula handle 90 is seated within the insert 32 such that each of the ridges 106 of the cone 100 are between bumps 50 of each pair of bumps 52, as illustrated in FIG. 15A.

The longitudinal axis A of the outer needle assembly 12 is aligned with the longitudinal axis B when the inner needle assembly 14 is coupled to the outer needle assembly 12, as illustrated in FIGS. 3 and 3A for example. The outer cannula 18 and the inner cannula 92 are arranged such that the outer distal set 68 and the outer proximal set 70 of openings 66 are each aligned along the longitudinal axes A and B with the inner distal set 130 and the inner proximal set 132 of openings 128 respectively.

Because the recess 38 is annular, the inner needle assembly 14 can be rotated with respect to the outer needle assembly 12 about the longitudinal axis A of the outer needle assembly 12, while maintaining alignment of the longitudinal axis A and the longitudinal axis B. The inner needle assembly 14 is generally rotated between a first position (FIG. 15A), a second position (FIG. 15B), and a third position (FIG. 15C).

As illustrated in FIG. 15A, in the first position the first ridge 106 a of the connection core 100 is between the bumps 50 of the first pair of bumps 52 a, the second ridge 106 b is seated between the bumps 50 of the second pair of bumps 52 b, and the third ridge 106 c is seated between the bumps 50 of the third pair of bumps 52 c. Each opening 66 of the outer distal opening group 72 a is aligned with an opening 128 of the inner distal opening group 134 a. In particular and with reference to FIGS. 16 and 17, the openings 66 of the first and the second outer distal arrays 74 a/74 b are aligned with the openings 128 of the first and the second inner distal arrays 136 a and 136 b respectively, thus permitting aspiration of material, such as bone marrow, there through. In contrast, the openings 66 of the outer intermediate and outer proximal arrays 76 a, 76 b, 78 a, and 78 b are not aligned with the openings 128 of the inner intermediate and inner proximal arrays 138 a, 138 b, 140 a, and 140 b, thus restricting aspiration of bone marrow there through.

With reference to FIG. 16, aspiration is performed using any suitable device, such as a syringe 400. The syringe 400 generally includes a luer lock 402 with threads 404 and a chamber 406 including a plunger 408 (chamber 406 and plunger 408 are conventional features that are partially illustrated). The syringe 400 is connected to the inner handle 90 through cooperation between the threads 404 of the luer lock 402 and the threads 142 at the proximal end 120 of the inner cannula 92. As the plunger 408 is pulled away from the luer lock 402, a negative pressure is established in the chamber 406 and in the passageway 126 of the inner cannula 92, thereby drawing bone marrow through the aligned openings 66 and 128 through the passageway 126 of the inner cannula 92 and into the chamber 406 of the syringe 400. Thus, when the inner needle assembly 14 is in the first position relative to the outer needle assembly 12, bone marrow can be aspirated from an area of the iliac crest 302 that is in close proximity to the outer distal opening group 72 a and the inner distal opening group 134 a.

With reference to FIGS. 15B and 18, to aspirate bone marrow from an area of the iliac crest 302 that is proximate to the outer intermediate opening group 72 b and the inner intermediate opening group 134 b, the inner needle assembly 14 is rotated 120° about the longitudinal axes A and B from the first position to the second position. In the second position, the first ridge 106 a is locked between the bumps 50 of the second pair of bumps 52 b, the second ridge 106 b is locked between the bumps 50 of the third pair of bumps 52 c and the third ridge 106 c is locked between the bumps 50 of the first pair of bumps 52 a. In this second position, as illustrated in FIG. 18, the openings 66 of the first and the second outer intermediate arrays 76 a/76 b are aligned with the openings 128 of the first and the second inner intermediate arrays 138 a/138 b respectively, thus permitting aspiration of material, such as bone marrow, there through. In contrast, the openings 66 of the outer distal and proximal arrays 74 a, 74 b, 78 a, and 78 b are not aligned with the openings 128 of the inner distal and proximal arrays 136 a, 136 b, 140 a, 140 b, thus restricting aspiration of bone marrow there through.

With reference to FIGS. 15 c and 19, to aspirate bone marrow from an area of the iliac crest 302 that is proximate to the outer proximal opening group 72 c and the inner proximal opening group 134 c, the inner needle assembly 14 is rotated 120 degrees about the longitudinal axes A and B from the second position to the third position. In the third position, the first ridge 106 a is locked between the bumps 50 of the third pair of bumps 52 c, the second ridge 106 b is locked between the bumps 50 of the first pair of bumps 52 a, and the third ridge 106 c is locked between the bumps 50 of the second pair of bumps 52 b. In this third position, as illustrated in FIG. 19, the openings 66 of the first and the second outer proximal arrays 78 a/78 b are aligned with the openings 128 of the first and the second inner proximal arrays 140 a/140 b respectively, thus permitting aspiration of material, such as bone marrow, there through. In contrast, the openings 66 of the outer distal and intermediate arrays 74 a, 74 b, 76 a, and 76 b are not aligned with the openings 128 of the inner distal and intermediate arrays 136 a, 136 b, 138 a, 138 b, thus restricting aspiration of bone marrow there through.

The outer proximal set 70 of openings 66 is substantially similar to the outer distal set 68 of openings 66. The inner proximal set 132 of openings 128 is substantially similar to the inner distal set 130 of openings 128. Thus, alignment of the openings 66 and the openings 128 of the outer proximal and inner proximal sets 70 and 132 respectively in each of the first position, the second position, and the third position is the same as the alignment of the openings 66 and 128 of the outer and the inner distal sets 68 and 130 in each of the first, the second, and the third positions.

Thus, cooperation between the outer needle assembly 12 and the inner needle assembly 14 permits aspiration of bone marrow from three different areas of the iliac crest 250. The three different areas are relatively offset both radially and longitudinally without having to move the outer needle assembly 12. Such movement may cause patient discomfort and increase the complexity of the procedure.

With additional reference to FIG. 20, another bone marrow aspiration assembly according to the present teachings is illustrated at reference numeral 10′. The aspiration assembly 10′ is similar to the assembly 10 described above and thus like features are designated with the same reference numerals, but include the prime symbol (′). The assembly 10 generally includes an outer needle assembly 12′ including an outer cannula 18′ and an inner needle assembly 14′ including an inner cannula 92′.

The outer cannula 18′ and the inner cannula 92′ are both flexible and can be made of any suitable flexible material, such as a suitable polymer or Nitinol. The outer cannula 18′ is illustrated as including slots 80′ and the inner cannula 92′ is illustrated as including slots 129′ arranged in the same manner as illustrated in FIG. 8 on the assembly 10 (i.e. proximal, intermediate, and distal groups of slots 80/129 each positioned 120° apart radially). However, the slots 80′ and 129′ can be provided in any suitable arrangement and/or shape to permit aspiration through selective slots 80′ and 129′ (or openings 66/128) by rotating the inner cannula 92′ with respect to the outer cannula 18′. For example, the slots 80′ and 129′ can be arranged in two groups of slots 80′/129′ positioned 120° apart radially or can have the arrangement of circular openings 66/128 illustrated in, for example, FIGS. 7A and 7B.

With reference to FIG. 21, a bone piercing needle is illustrated at reference numeral 450. The bone piercing needle 450 includes a head 452, a cannula 454 terminating at an open tip 456, and a collar 458 between the head 452 and the cannula 454. The bone piercing needle 450 is substantially shorter in length than the bone marrow aspiration assembly 10′ and is rigid throughout. The cannula 454 is about 3-4 inches in length. The bone piercing needle 450 can be made of any suitable rigid material, such as a metal.

With additional reference to FIG. 22, use of the bone piercing needle 450 and the aspiration assembly 10′ to aspirate bone marrow from the pelvis 300 will now be described. The bone piercing needle 450 is driven into the pelvis 300 such that the collar 458 is at an outer surface of the iliac crest 302 and the cannula 454 extends through the cortical bone 304 to the cancellous bone 306. With the inner needle assembly 14′ mated with the outer needle assembly 12′, the inner and outer cannulas 18′ and 92′ are inserted into the iliac crest 302 either through the cannula 454 when the bone piercing needle 450 is left in the pelvis 300 or through the opening created in the pelvis 300 when the bone piercing needle 450 is removed. Because the inner and outer cannulas 18′ and 92′ are flexible, they are able to track along a curved perimeter 308 of the iliac crest 302, which is typically a rich source of bone marrow. To aspirate bone marrow from the iliac crest 302, a syringe is attached to the assembly 10′, which is operated in the same manner as the assembly 10 described above.

The assembly 10′ may also include the trocar 200 of FIG. 10, or any other suitable trocar or rigid device, which can be inserted within the outer cannula 18′ to facilitate insertion of the outer cannula 18′ into the iliac crest 302. The outer cannula 18′ may have an open tip 60′ as illustrated in FIG. 20, or it may have a closed tip (FIG. 20A). When the tip 60′ is open, the trocar 200 may extend beyond the tip 60′.

With additional reference to FIG. 23A, an introducer needle is illustrated at reference numeral 500. The introducer needle 500 generally includes a handle 502 and a cannula 504. The handle 502 includes a center connector 506 with an annular recess 508 extending about an exterior surface thereof. The connector 506 includes an opening 510 extending through a center thereof. The opening 510 extends through the handle 502 and is in communication with the cannula 504.

The cannula 504 includes a proximal end 512 secured to the handle 502 and a distal end 514 that is opposite to the proximal end 512. The distal end 514 includes an open tip 516 that may include sharpened edges 518 to facilitate positioning of the of the introducer needle 500 at an implantation site. The cannula 504 defines a channel 520 that extends between the proximal end 512 and the distal end 514. The channel 520 is in cooperation with the opening 510 to provide a continuous passageway through the introducer needle 500.

The cannula 504 is rigid and curved between the proximal end 512 and the distal end 514. The cannula 504 can have any suitable shape and any suitable degree of curvature to match or closely approximate either the overall natural curve of the iliac crest or specific portions thereof to facilitate positioning the cannula 504 proximate to areas with the greatest amount of bone marrow. The cannula 504 can be curved along its entire length or only portions thereof. The cannula 504 can be made of any suitable material, such as a suitable metal. The cannula 504 can optionally include holes along its length in communication with the channel 520, such as the openings 66 or the slots 80 of the outer cannula 18, which can be provided in any suitable size, shape, and arrangement, such as the arrangement herein with respect to the outer cannula 18.

A flexible needle assembly 550 is illustrated in FIG. 23B. The flexible needle assembly 550 is substantially similar to the inner needle assembly 14′ and therefore similar features are designated with the same reference numerals, but with the prime (′) symbol added. Unlike the inner needle assembly 14′, the assembly 550 as illustrated includes only a single pair of slots 129′ at the distal end 122′, but can include any suitable number of slots 129′ or openings (such as openings 128 as arranged in FIGS. 2 and 7A) in any suitable shape, number, or arrangement, such as is provided with the inner needle assembly 14 or 14′.

With additional reference to FIG. 24, use of the curved introducer needle 500 to aspirate bone marrow from the iliac crest 302 of the pelvis 300 will now be described. The cortical bone 304 of the iliac crest 302 is initially pierced with the bone piercing needle 450, which is driven within the iliac crest 302 such that the open tip 456 extends to within the cancellous bone 306. The cannula 504 of the introducer needle 500 is then inserted through the cannula 454 of the bone piercing needle 450 and into the iliac crest 302. The bone piercing needle 450 can be curved, as illustrated, to accommodate the introducer needle. The curvature of the cannula 504 is similar to the curvature of the perimeter 308 of the iliac crest 302 and thus the cannula 504 can be positioned proximate to the perimeter 308, an area rich in bone marrow, along at least a majority of its length. Alternatively, the bone piercing needle 450 can be removed prior to insertion of the cannula 504, which can be inserted through the opening in the iliac crest 302 formed by insertion of the cannula 454.

Once the cannula 504 of the introducer needle 500 is at an area of the iliac crest 302 from which bone marrow is to be aspirated, the flexible needle assembly 550 can be mated with the introducer needle 500 such that the tabs 102′ are coupled to the annular recess 508 and the inner cannula 92′ extends through the channel 520 such that the distal end 122′, including a portion with the slots 129′ (illustrated as a plurality of circular openings in FIG. 24A), extends beyond the distal end 514. To aspirate bone marrow, a syringe 400 can be coupled to threads of the cannula handle 90′ (in a manner substantially similar to that illustrated in FIG. 16) to aspirate bone marrow through the slots 129′ of the inner cannula. Alternatively, a syringe can be attached directly to the connector 506 of the introducer needle 500 to aspirate bone marrow directly through the open tip 516. The flexible needle assembly 550 can be rotated to aspirate bone marrow from different areas of the iliac crest 302.

When the cannula 504 includes the slots 80 or the openings 66 of the outer cannula 18 and the cannula 92′ includes the slots 129 or the openings 128 of the inner cannula 92, as arranged in FIGS. 7A and 8 for example, bone marrow may be aspirated through select slots 80/129 or openings 66/128 by rotating the flexible needle assembly 550 relative to the cannula 504 to provide selective alignment, and selective aspiration, through the different slots 80/129 or openings 66/128 in the same manner as described in FIGS. 15 and 17-19 with respect to use of the outer needle assembly 12 and the inner needle assembly 14.

With additional reference to FIGS. 25 and 26, another bone marrow aspiration assembly according to the present teachings is illustrated at reference numeral 610. The aspiration assembly 610 generally includes an outer needle assembly 612 and an inner needle assembly 614.

The outer needle assembly 612 generally includes an outer handle 616 and an outer cannula 618. The outer handle 616 includes a proximal surface 620 and a distal surface 622. At approximately a center of the distal surface 622 is a raised neck 624, which defines a distal opening 626 of a through bore 628. A proximal opening 630 of the through bore 628 (FIG. 27) is near the proximal surface 620 of the outer handle 616 between a first wing 632 and a second wing 634 of the outer handle 616. The proximal opening 630 is defined by a proximal center flange 636, which is between, but spaced apart from, the first wing 632 and the second wing 634. Extending from an exterior surface of the center flange 636 is a locking knob 638 (FIGS. 25 and 28). The locking knob 638 may be at any suitable position on the exterior surface of the center flange 636, such as halfway between the first wing 632 and the second wing 634.

With reference to FIG. 26, the outer handle 616 defines a receptacle 642 between the distal opening 626 and the proximal opening 630. The receptacle 642 is sized and shaped to receive a first locking tab 650 and a second locking tab 652, which is substantially the same as the first locking tab 650. Each of the first locking tab 650 and the second locking tab 652 include an outer surface 654 and an inner surface 656 that is opposite to the outer surface 654. At a center of each of the inner surfaces 656 is a semi-circular retainer 658 configured to retain an insert 660 (further described herein) within the through bore 628. On opposite sides of each retainer 658 are clips 662, each of which are sized and shaped to cooperate with apertures 664 (FIG. 27) defined in the outer handle 616 at the receptacle 642.

With reference to FIGS. 26 and 27, the insert 660 generally includes a proximal end 670 and a distal end 672. The insert 660 defines an insert bore 674, which extends between the proximal end 670 and the distal end 672. At the proximal end 670, the insert 660 defines a generally planar proximal surface 676. Between the proximal end 670 and the distal end 672 is a neck portion 678. As illustrated in FIG. 27, the insert 660 is seated within the through bore 628 and secured therein with the first and second locking tabs 650, 652 through interaction between the retainers 658 and the neck portion 678 of the insert 660.

The outer cannula 618 includes a proximal end 680 and a distal end 682, which is opposite to the proximal end 680. The proximal end 680 is secured within the insert bore 674 of the insert 660 in any suitable manner, such as with a fastener or an overmold, in instances where the insert 660 is polymeric. The distal end 682 includes sharpened edges or teeth 684 suitable to pierce bone, for example. As illustrated, the outer cannula 618 defines a plurality of elongated slots 80 in the configuration of FIG. 8B described in detail above. However, the outer cannula 618 can define openings of any suitable size or shape. For example, the outer cannula 618 can includes the circular openings 66 in the arrangement of FIG. 7A described above, the spaced apart slots 80 of FIG. 8, which are shorter than the slots 80 of FIG. 8B, or circular openings 128 in the arrangement of FIG. 8C described above. The outer cannula 618 can be made of any suitable metal, such as a suitable metal or polymer. The outer cannula 618 can be rigid or flexible as well.

The inner needle assembly 614 generally includes an inner handle 702 and an inner cannula 704. The inner handle 702 includes a proximal end 706 and a distal end 708. With additional reference to FIG. 29, at a center of the inner handle 702 is a connection cone 710. The connection cone 710 has a tapered outer surface 712 such that an outer diameter of the tapered outer surface 712 is greatest proximate to the distal end 708. The connection cone 710 defines a connection channel 714 that extends through the connection cone 710. The inner cannula 704 extends from within the connection channel 714 and is secured therein in any suitable manner, such as with a suitable adhesive or mechanical locking feature.

The connection channel 714 is aligned with a syringe receptacle 720 at the proximal end 706 of the inner handle 702. The syringe receptacle 720 includes a tapered inner surface 722 that tapers inward from the proximal end 706. Opposite to the tapered inner surface 722 is an outer surface 724, which includes threads 726 for cooperating with a suitable syringe, such as threads of a Luer lock. At the proximal end 706 of the inner handle 702 are handle tabs 730. While three separate handle tabs 730 are arranged at approximately 120° about the proximal end 706, any suitable number of handle tabs 730 can be provided at any suitable orientation to facilitate alignment of the inner cannula 704 with respect to the outer cannula 618, as further described herein.

Surrounding the connection cone 710 is a seal or washer recess 732. The washer recess 732 is generally annular and defined within the inner handle 702. Seated within the washer recess 732 is a seal or washer 736. The washer 736 can be any suitable seal or washer made of any suitable material, such as a suitable polymer. The washer 736 can be flexible or rigid. As illustrated in FIG. 27, the washer 736 can have a generally square cross-section. The washer 736 may have any other suitable cross-sectional shape as well, such as circular. The washer 736 can be secured within the washer recess 732 in any suitable manner, such as with a press-fit, a suitable adhesive, or with a suitable mechanical connection. As illustrated in FIG. 27 and further described herein, when the inner needle assembly 614 is connected to the outer needle assembly 612, the washer 736 contacts the planar proximal surface 676 of the insert 660 to provide a seal therebetween. In addition to being included with the bone marrow aspiration assembly 610, the seal or washer 736, or any other suitable seal, can be provided between the inner needle assembly and the outer needle assembly of any other embodiment described herein. For example and with reference to FIG. 3A, the washer 736 or any other suitable seal can be provided between the insert 32 and the connection region 98, such as between the connection tabs 102.

Surrounding the connection cone 710 and the washer 736 is a locking skirt 740. The locking skirt 740 generally includes a first locking channel 742, a second locking channel 744, and a third locking channel 746. The first, second, and third locking channels 740, 742, and 744 are spaced apart about the locking skirt 740 at about 120° intervals. The first locking channel 742 is aligned with a number “1” printed on an exterior of the inner handle 702 (FIG. 29), the second locking channel 744 is aligned with a number “2” printed on the exterior of the inner handle 702 (FIG. 30), and the third locking channel 746 is aligned with a number “3” printed on the exterior of the inner handle 702 (FIG. 31). Each of the first, second, and third locking channels 742, 744, and 746 generally include a first portion 748 that extends from the distal end 708 in a direction generally parallel to the connection channel 714 and the inner cannula 704. A second portion 750 extends from the first portion 748 in a direction that is generally perpendicular to the connection channel 714 and the inner cannula 704. Each of the second portions 750 are partially defined by a tab 752 with a raised surface 756.

The first, second, and third locking channels 742, 744, and 746 are sized and shaped to receive the locking knob 638 of the outer needle assembly 612 to facilitate selective and orderly alignment of the inner cannula 704 with respect to the outer cannula 618. For example, in position “1” the inner cannula 704 is arranged such that the locking knob 638 is seated within the first locking channel 742, which results in only the outer distal opening group 72 a being aligned with the inner distal opening group 134 a. In position “2”, the inner cannula 704 is arranged such that the locking knob 638 is seated within the second locking channel 744, which results in only the outer intermediate opening group 72 b being aligned with the inner intermediate opening group 134 b. In position “3”, the inner cannula 704 is arranged such that the locking knob 638 is seated within the third locking channel 746, which results in only the outer proximal opening group 72 c being aligned with the inner proximal opening group 134 c.

As illustrated in FIG. 26, the inner cannula 704 includes a proximal end 760, which is secured within the connection channel 714 of the insert 660, and a distal end 762 that terminates at a closed tip 764. As illustrated, the inner cannula 704 includes a plurality of circular openings 128 provided in the same number and arrangement of the inner cannula 92 described above with respect to FIG. 8B. The inner cannula 704 can define openings of any suitable size or shape. For example, the inner cannula 704 can include the circular openings 128 in the arrangement of FIG. 7A described above, the elongated slots 129 of FIGS. 8A and 8C, or slots that are shorter than the slots 129, such as the slots 80 of the outer cannula 18 (FIG. 8A), which are shorter than the slots 129. Regardless of the types of openings provided, they are arranged into three linearly aligned groups—an inner distal opening group 134 a, an inner intermediate opening group 134 b, and an inner proximal opening group 134 c.

Use of the bone marrow aspiration assembly 610 will now be described. The bone marrow aspiration assembly 610 is used in a manner substantially similar to use of the other bone marrow aspiration assemblies described herein, such as the bone marrow aspiration assembly 10. Thus, the use of the other bone marrow aspiration needle assemblies described herein also applies to the assembly 610. To pierce cortical bone 304 and cancellous bone 306 of the iliac crest 302 (FIGS. 12 and 13), the trocar 200 can be mounted to the outer needle assembly 612 by suitably modifying the trocar handle 202 so that the trocar handle 202 is configured to mate with the outer handle 616. The cortical bone 304, the cancellous bone 306, and the iliac crest 302 can be pierced in substantially the same manner as described above in connection with the discussion of the assembly 10 and the trocar 200.

The inner needle assembly 614 is coupled with the outer needle assembly 612 such that the inner cannula 704 extends through the outer cannula 618 and the inner opening groups 134 a, 134 b, and 134 c are each longitudinally aligned with the outer opening groups 72 a, 72 b, and 72 c respectively. But only one of the inner opening groups 134 a, 134 b, and 134 c is radially aligned with one of the outer opening groups 72 a, 72 b, and 72 c. As illustrated in FIG. 25 for example, the slot 80 of the outer distal opening group 72 a is radially aligned with the openings 128 of the inner distal opening group 134 a when the inner handle 702 is in the first position of FIG. 1, in which a numeral “1” printed on an exterior of the inner handle 702 is aligned with the locking knob 638 and the inner handle 702 is arranged such that the locking knob 638 is seated within the first locking channel 742 beyond the raised surface 756 to lock the inner handle 702 in the first position.

In the first position of FIG. 1, a suitable syringe (not shown) can be connected to the inner handle 702 at the proximal end 706 through cooperation with the threads 726 to draw bone marrow aspirate, for example, through the slots 80 and openings 128 of the aligned outer distal opening group 72 a and the inner distal opening group 134 a. Due to the presence of the washer 736 between the insert 660 and the inner handle 702, air is restricted from passing into the inner cannula 704 at the interface between the insert 660 and the inner handle 702, thereby decreasing the amount of negative pressure that must be exerted by the syringe in order to draw bone marrow aspirate, for example, through the inner cannula 704. Without the washer 736, it would be more difficult to draw the bone marrow aspirate through the inner cannula 704 and into the attached syringe.

With additional reference to FIG. 30, to draw bone marrow aspirate, for example, through the inner and outer intermediate opening groups 72 b/134 b, the inner handle 702 is unlocked from the knob 638 and rotated 120° so that the second locking channel 744, which is aligned with the numeral “2”, is aligned with the knob 638. The inner handle 702 is locked onto the knob 638 by positioning the knob 638 within the second locking channel 744 beyond the raised surface 756. Thus, in position “2” the inner and outer intermediate opening groups 72 b/134 b are radially aligned.

With additional reference to FIG. 31, to draw bone marrow aspirate, for example, through the inner and outer proximal opening groups 72 c and 134 c, the inner handle 702 is unlocked from the knob 638 and rotated 120° so that the third locking channel 746, which is aligned with the numeral “3”, is aligned with the knob 638. The inner handle 702 is locked onto the knob 638 by positioning the knob 638 within the third locking channel 746 beyond the raised surface 756. Thus, in position “3” the inner and outer proximal opening groups 72 c/134 c are radially aligned. The foregoing description of the embodiments has been provided for purposes of illustration and description. It is not intended to be exhaustive or to limit the invention. Individual elements or features of a particular embodiment are generally not limited to that particular embodiment, but, where applicable, are interchangeable and can be used in a selected embodiment, even if not specifically shown or described. The same may also be varied in many ways. Such variations are not to be regarded as a departure from the invention, and all such modifications are intended to be included within the scope of the invention. 

1. A bone marrow aspiration assembly comprising: an outer cannula assembly including an outer handle and an outer cannula defining a first passageway and including a plurality of first openings between a first end and a second end of the first passageway; an inner cannula assembly including an inner handle and an inner cannula defining a second passageway and configured to be received within the first passageway, the inner cannula includes a plurality of second openings between a first end and a second end of the second passageway; and a flexible seal mounted to the inner handle and positioned such that the seal contacts the outer cannula assembly when the inner cannula assembly is in cooperation with the outer cannula assembly to create a substantially airtight seal therebetween; wherein the inner cannula is longitudinally and axially movable relative to the outer cannula to simultaneously selectively align at least one first opening with at least one second opening to permit aspiration of bone marrow therethrough and to misalign at least one of another first opening and at least one of another second opening to restrict aspiration of bone marrow therethrough.
 2. The bone marrow aspiration assembly of claim 1, wherein the first openings include elongated slots and the second openings are circular.
 3. The bone marrow aspiration assembly of claim 2, wherein the plurality of first openings are arranged in distal, intermediate, and proximal groups, each group includes a first outer array of slots radially spaced apart 180° from a second outer array of slots, the first arrays of each of the distal, intermediate, and proximal groups are not radially aligned, and the second arrays of each of the distal, intermediate, and proximal groups are not radially aligned.
 4. The bone marrow aspiration assembly of claim 3, wherein the plurality of second openings are arranged in distal, intermediate, and proximal groups that each include a first inner array of circular openings radially spaced apart 180° from a second inner array of circular openings, the first inner arrays of each of the distal, intermediate, and proximal groups are radially aligned, and the second inner arrays of each of the distal, intermediate, and proximal groups are radially aligned.
 5. The bone marrow aspiration assembly of claim 4, wherein each of the first outer arrays include a single elongated slot and each of the second outer arrays include a single elongated slot; and wherein each of the first inner arrays include a first plurality of circular openings and each of the second inner arrays include a second plurality of circular openings that has the same number of openings as each of the first inner arrays.
 6. The bone marrow aspiration assembly of claim 5, wherein each of the first inner arrays include only four circular openings and each of the second inner arrays include only four circular openings.
 7. The bone marrow aspiration assembly of claim 1, wherein the flexible seal is polymeric.
 8. The bone marrow aspiration assembly of claim 7, wherein the flexible seal includes one of a circular cross-section or a square cross-section.
 9. The bone marrow aspiration assembly of claim 1, wherein the inner handle defines a first locking channel, a second locking channel, and a third locking channel spaced apart at about 120° intervals around a locking skirt of the inner handle, each of the first locking channel, the second locking channel, and the third locking channel are operable to individually cooperate with a locking knob of the outer cannula assembly.
 10. The bone marrow aspiration assembly of claim 9, wherein cooperation between the locking knob and the first locking channel aligns distal first openings with distal second openings; wherein cooperation between the locking knob and the second locking channel aligns intermediate first openings with intermediate second openings; and wherein cooperation between the locking knob and the third locking channel aligns proximal first openings with proximal second openings.
 11. A bone marrow aspiration assembly comprising: an outer cannula assembly including an outer handle and an outer cannula defining a plurality of elongated slots that are arranged in distal, intermediate, and proximal groups along a first length of the outer cannula, each group includes only a pair of opposing elongated slots, the elongated slots of neighboring groups are arranged about 120° relative to each other; and an inner cannula assembly including an inner handle and an inner cannula defining a plurality of circular openings that are arranged in distal, intermediate, and proximal groups along a second length of the inner cannula, each group includes opposing circular openings, the circular openings of neighboring groups are longitudinally aligned; and a polymeric seal between the inner cannula assembly and the outer cannula assembly; wherein the inner cannula is rotated radially to selectively align the circular openings of only one of the distal, intermediate, and proximal groups of the inner cannula with the elongated slots of only one of the distal, intermediate, and proximal groups of the outer cannula to permit aspiration therethrough.
 12. The bone marrow aspiration assembly of claim 11, wherein the polymeric seal is mounted to the inner handle in a recess defined within the inner handle.
 13. The bone marrow aspiration assembly of claim 11, wherein the polymeric seal has a circular cross-section.
 14. The bone marrow aspiration assembly of claim 11, wherein the polymeric seal has a square cross-section.
 15. The bone marrow aspiration assembly of claim 11, wherein the inner handle defines a first locking channel, a second locking channel, and a third locking channel spaced apart at about 120° intervals around a locking skirt of the inner handle, each of the first locking channel, the second locking channel, and the third locking channel are operable to individually cooperate with a locking knob of the outer cannula assembly.
 16. The bone marrow aspiration assembly of claim 11, wherein each of the distal, intermediate, and proximal groups of the inner cannula include a first array of only four circular openings opposing a second array of only four circular openings.
 17. A bone marrow aspiration assembly comprising: an outer cannula assembly including: an outer handle including a locking knob; an outer cannula defining a plurality of elongated slots that are arranged in distal, intermediate, and proximal groups along a first length of the outer cannula, each group includes only a pair of opposing elongated slots, the elongated slots of neighboring groups are arranged about 120° relative to each other; and an inner cannula assembly including: an inner handle including a locking skirt defining a first locking channel, a second locking channel, and a third locking channel spaced apart at about 120° intervals around the locking skirt, each of the first locking channel, the second locking channel, and the third locking channel are operable to individually cooperate with the locking knob of the outer handle; an inner cannula defining a plurality of circular openings that are arranged in distal, intermediate, and proximal groups along a second length of the inner cannula, each group includes opposing circular openings, the circular openings of neighboring groups are longitudinally aligned; and a polymeric seal between the inner cannula assembly and the outer cannula assembly, the polymeric seal includes one of a circular cross-section or a square cross-section; wherein the inner cannula assembly is rotated radially and connected to the outer cannula assembly by selectively locking the locking knob within one of the first, second, or third locking channels to selectively align the circular openings of only one of the distal, intermediate, and proximal groups of the inner cannula with the elongated slots of only one of the distal, intermediate, and proximal groups of the outer cannula to permit aspiration therethrough.
 18. The bone marrow aspiration assembly of claim 17, wherein the inner cannula and the outer cannula are rigid.
 19. The bone marrow aspiration assembly of claim 17, wherein the inner cannula and the outer cannula are flexible.
 20. The bone marrow aspiration assembly of claim 17, wherein the inner handle includes a printed number “1” aligned with the first locking channel, a printed number “2” aligned with the second locking channel, and a printed number “3” aligned with the third locking channel to enable selective and orderly alignment between one of elongated slots of the distal group of the outer cannula with circular openings of the distal group of the inner cannula, elongated slots of the intermediate group of the outer cannula with circular openings of the intermediate group of the inner cannula, or elongated slots of the proximal group of the outer cannula with circular openings of the proximal group of the inner cannula. 